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More on kissing spines and pain..

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  • More on kissing spines and pain..

    I posted here earlier this year and everyone was great with good info and well wishes. I'd like to see if any one can share any more with my continuing story.

    I have ben trying to figure out my horses' problems for well over a year. Thinking at first it was behavioral and then realizing that it was most definitly pain when he bucked me off from a stand still. I was on a very relaxed horse with his head down - he moved slightly and I could tell something pinched, his reaction was violent. It is very sad... I have not ridden him since.

    I am near New Bolton, a very good vet hospital. Unfortunately, everytime I take him I present a basically sound horse that looks like a beginner could ride him. It is very, very frustrating! I belive he comes across sound because the adrenilin is going (he is a high strung TB that stresses with trailering and new enviornments). He has had the full check up - x-rays, ultra-sounds, bone scan, etc. He does have 3 vertebrae touching just behind the withers where I sit. He also had Lyme's Disease and was on 15 weeks of Doxy. None of the vets put much weight on the Lyme's or kissing spines. They don't think it is a problem - UGH!

    He is getting accupuncture and chiropractic care. I lunge and long line in side riens. He goes long and low very well. However his nature, in the pasture, head held high - he is 17.1 and we nick named him the giraffe.

    When working at home (lunging or long lining since I no long ride him), when I get him into a big trot or canter he cross canters, bucks and basically looks uncomfortable. Of course he cantered beautifully for the vets just last week. He never put a foot wrong. They have seen a video taped session showing the uncomfortable horse. But if they can not see it in person, keep it consistant so they have something to block and to then compare, they tell me they can not do anything. I understand, but my frustration is unbearable.

    In this last visit my vet prescribed gabapentin. I am to give him 10 pills, twice a day for 2 weeks and see if it helps. The pills are 600 mgs. Even she said, we are grasping at straws. I have not started him on the pills yet, I was doing research first.

    Has anyone used this drug? Had similar situations or experiences?

  • #2
    Gabapentin has been excellent for Blush. She has bony change at C6/C7 which has been causing some nerve root irritation/compression/impingement. We injected the neck and put her on gabapentin at the same time. Another one of my vets believe Blush is in neurological wind up (where the sympathetic nervous system in in overdrive and all touch = pain) which gabapentin also treats.

    I was shocked at how different Blush was when I first put her on gabapentin. She had become very, very withdrawn. On gabapentin, her ears were up and she was engaged in what was going on around her. Gabapentin does nothing for her orthopedic pain, but does wonders for her neuropathic pain.

    The dose they gave you is HUGE. My vet is using this dose: Gabapentin for the treatment of neuropathic pain in a pregnant horse. Blush is about 1300 lbs and is on 1400 mg twice a day. We tried to drop to 1300, but I did not see the same response, so I upped her back to 1400. I would be concerned about 6000 mg twice a day as I don't think there is nothing in the literature to support a dose that large. I would be curious as to why the dose is so big. In fact, I'd probably be the pain in the ass client who would call and say "I found a paper that used a dose of 2.5 mg/kg. Can you tell me why we're using a dose that is in such excess of that?" before I started treating.


    • #3
      Foxford, I am in nearly the same boat. Have been diagnosing for almost a year. No one has said KS yet, but the more I read, the more I am convinced this might be part of what is going on.

      It started out as big, "I'm in pain" bucks which I interpreted as behavior b/c he was still new to me and I was getting to know him. Then it was not going forward, counter countering, inability to get right lead, hated grooming and then refusing jumps. He loves to jump, esp. XC but it was so inconsistent...I could show one weekend beautifully and then fall apart in Dressage before even jumping at the next event (note: we have only been competing at Novice). XC schooling would be fun one week, then it would be a bronc show the next time, at the same facility (so not being spooky). Finally I understood it was pain and then it all started...

      We did hock injections, SI injection, chrio, massage & acupuncture. He had a horrible impaction colic right when things were at their worst and had to go up to Athens but didn't end up having surgery. The last year was very frustrating and very expensive as well.

      I finally found a great Chiro who relieved his SI pain and everything else started getting better. He had 12 weeks off to just be a horse and gain weight, which he did with the great people he boarded with while I was gone for the summer. He seemed to be a new horse when I returned from Colorado.

      I have taken great care to slowly leg him up and he's getting back in shape. We had a big play day with the hounds (1x a week for 2 weeks) and he worked harder than he had in ages although it was 95% trotting. It's always been the canter that causes pain for him.

      Next step is to see if it is KS I suppose. Sorry I am not helping with solutions but I am going to the vet this week and will post what they say. His massage person is supposed to come over today to palpate his spine. There is no way I can afford surgery but I surely don't want him to be in pain. So I am researching it all like the rest of us. Sorry this ended up so long.
      Last edited by Altitude Rider; Sep. 28, 2008, 02:00 PM. Reason: I took out an unrelated subject that was in the message
      Ready ~ 1999-2009 ~ you were bigger than life!
      Stickers ~ 1985-2011 ~ Cody's BFF
      I miss you both very much!


      • Original Poster

        Simkie, I am going to call my vet tomorrow. Our doses are really different! Can not imagine why my guy would get 6000 mgs a day your horse gets 1400. That is a big difference on horses that weigh about the same.

        Altitude Rider, your horse sounds narcoleptic. Have you consulted a vet about that? Not sure about the bucking, but x-rays will be the only thing to tell you if kissing spines are a problem. Good luck!


        • #5
          foxford (and others)-what does the chiro find when treating your horse?

          Is he reactive in the same places? If so, where?

          What is gabapentin? I am not familiar with it.


          • #6
            foxford, I would absolutely mention that study I linked My vet was not able to find any other articles about using gabapentin in equines in the literature.

            LMH, gabapentin is a human anti-seizure medication. It's also used in humans for wind up pain and other neuropathic pain. It's very good on neuropathic pain and not of much use for orthopedic pain. It's a not uncommon med to see in small animal practice as well. It is fairly new and novel in equines.

            My chiro/acupuncture person found Blush very reactive all along her back (exquisitely painful) which led her to diagnose wind up pain. Blush was not particularly reactive in the neck, I don't think. Following neck injections and gabapentin, Blush was more sore in her SI area and had no/very little back pain. There is a LOT going on with Blush, though, so it's very hard to say what has been made better with the neck injections. We still have the hind end issues to deal with.


            • #7
              I am sorry to sound so dense here-but what is wind up pain?

              Is it like pain from anxiety? Which is what is sounds like?


              • #8
                Current chiro says it's the SI area that is still a problem and may always be an issue to some degree. That area has improved dramatically in the last 4 months. I treat him like he is super fragile when I ride b/c I have been so scared that this is all going to come back. We haven't been to the Chiro in a few weeks but I will get him on the schedule after I speak with the vet.

                The first Chiro we saw said he thought it was his withers and now it seems that could be accurate. That chiro didn't accomplish much overall but now I will rethink the withers.

                Last two times I lunged him (which was only to see how he is moving) he randomly bends his neck way to the inside left when going left. When going rt he tends to counter bend to the left.

                For the first three weeks after his time off he was stretching a lot more when I rode, being quiet, happy for the light work and going well on the lunge, I was so happy. Now it seems like something has happened to aggrevate the old injury again so I am sort of freaking out.

                He was doing handstands and bucking a lot a couple of mornings last week when the temps dropped so maybe he just kinked something. Or re injured something.

                Calling vet in AM regarding sleeping spells and back.
                Ready ~ 1999-2009 ~ you were bigger than life!
                Stickers ~ 1985-2011 ~ Cody's BFF
                I miss you both very much!


                • #9
                  Altitude Rider, a course of gabapentin may not be a bad idea for your horse. If he improves, you're dealing with neuropatic pain and should look closer at the spine. If he does not improve, then you are not dealing with neuropathic pain and should look elsewhere.

                  Honestly, the response I've seen in Blush to gabapentin has been huge. If I had any equine that I thought had nerve pain, I would jump to put them on gabapentin. I would also use it in any equine that was overly reactive to touch (like your typical OTTB that can't stand to be groomed...)


                  • Original Poster

                    Simkie, I am still reserved about gabapentin. But, I have not used it yet. We'll see. I also am not sure what you mean by "wind up pain".

                    LMH - My understanding is that gabapentin is a drug that slows the messages between the nerves. It is used in humans for nerve pain in people using prosthetics and with problems with shingles. In horses it was started for nerve pain from laminitis. Now it is being used for back pain (my horse).

                    The chiropractic treatments have been really helpful for my guy, but have not shown anything significant. At best, his ribs where often an issue when I was riding.

                    Altitude rider - where are you located? Are you near a vet hospital or school? Perhaps you should consider a good work up for your guy. Maybe to include a bone scan. It is expensive, but it can give you a lot of information.


                    • #11
                      Foxford, there is a ton of info out there on wind up pain: http://www.google.com/search?hl=en&q...in&btnG=Search

                      After seeing gabapentin help Blush, I have reservations about the DOSE your vets gave you, but not about the drug itself. It has been very, very good for my horse with zero side effects.


                      • Original Poster

                        Wow, Thanks for the google search. I did not realize it was real term. I will read that info. in depth later. Gotta run now.

                        I too am concerned on the dosage for my guy. I will post what my vet says after I talk to her.

                        Keep your fingers crossed that gabapentin is a miracle drug for Lucky. I would love to ride my big boy again! I am running out of options...


                        • #13
                          I'll talk to my vet about Gabapentin. He had a full work-up last spring and overall is so much better but I still think something is missing. It seems like if I can keep him comfortable then I can build up his muscles better which will help overall.

                          I really think he wants to go back to work, he loves doing anything (well he doesn't really love Dressage) he has such a big heart and yet is so stoic. I really believe it hurts if I do any more than walk/trot but he loves to go on his hacks. When we w/t on baby hills, esp. going downhill, it seems to be hard for him. He's only 9 and my only ridable horse right now.

                          May be time for a 2nd opinion. the closest good University vet is 3 hours away which isn't bad but I am sooo broke right now. Also dealing with Squamous Cells in my old gray boy, hard to prioritize who needs the most care.

                          Massage lady didn't make it over to palpate his spine yesterday, hopefully today. That will at least be a start and I will report what she says.

                          Thanks for all the info, it really helps me try to get an understanding of what is going on. And that I am not the only one!!
                          Ready ~ 1999-2009 ~ you were bigger than life!
                          Stickers ~ 1985-2011 ~ Cody's BFF
                          I miss you both very much!


                          • Original Poster

                            I read up on Wind Up Pain - very interesting. I had not heard of that before. Thank you.
                            I talked to my vet and she was thrilled to hear that your horse has responded so well to gabapentin. She said that 6000mgs is what they have been using at New Bolton, actually 3 times a day. Twice was all I could manage, so that is how she scripted it. The side effects that they know of are that your horse can get sleepy. She told me just to keep an eye on him and see what happens. So that is what I will do. I can back it off later if it is working. Keep your fingers crossed.
                            How long was it before you saw a difference?


                            • #15
                              I saw a difference within 24 hours and it was night and day. Blush was very, very different on gabapentin.

                              It sounds like you're all set, but if your vet would like to speak with mine about the gabapentin dose or use, Amy would be happy to speak with her. PM me if you'd like her contact info.

                              I believe Ty Wallas (Wallis? Wallace?) at CSU is also using gabapentin to treat wind-up pain. He's another resource...


                              • #16
                                Not sure if you know about Mesotherapy, but I wanted to mention just in case it might help someone. We had a horse that had back pain....long story short, we were afraid of KS. Thankfully, that was not the case. However, we learned about Mesotherapy which is commonly used in France for back pain. It is also used in plastic surgery clinics when humans have surgery to combat the pain. This worked GREAT for us and it was not invasive. I can't tell you how huge the difference was and in just 3-4 days. I don't know how long it lasts, but so far so good! Google it and read for yourself. I want to see if I can get a treatment myself next time! LOL


                                • #17
                                  If there are only 3 spines all bent together, surgery may be a complete cure, as it was for my mare. She had the classic symptoms of high head carriage, bucking and blowing up on the longe (too dangerous to ride) and turning her head way around to the left side and holding it there after stopping. She was so painful that it was surgery or pasture retirement, as she could not have carried a foal. Her 3 kissing spines were at the lowest part of her back, under the sadddle (16-17??) Dr. Gayle Trotter ( surgery professor, now retired) from CSU did the surgery in my vet's clinic. It was a laydown day surgery and mare went home that night with a roll of cotton sutured to her back, that is all.. The center of the 3 kissing spines was reduced until it no longer touched anything. After her 6 week hand walking and gradual increase in pen size recovery, she was absolutely, amazingly pain free the first time I trotted her on the longe - had long flowing strides. I waited to ride until I could press hard on that spot without a reaction. I think it cost me about 2K 5 years ago for the surgery and associated X-rays. Dr. Trotter upped cost a little extra beyond what my vet would have charged, but his expertise was worth it. Shockwave had done nothing for this mare, same with injections.
                                  Comprehensive Equestrian Site Planning and Facility Design


                                  • #18
                                    Sometimes the drugs give you an interlude to try other supportive therapies. I have not found one specific one that is all over wonderful for these horses. It can be so frustrating. While we all tend to focus on the back or hocks few of us, especially professionals like vets, focus on the feet. The more I learn and experience the more I realize a good percentage of pain control is in the feet. And sadly I am realizing that many farriers just aren't doing the correct job. Both my kissing spines geldings stay comfortable if I keep their feet trimmed every 4 weeks with rasping every few days, saddle fit and really emphazing building up that topline. This, of course, is not the only part of therapy but it's a key element. Saddle fit is also very important. I am cautious about longeing a horse with KS b/c many have other issues that are greatly stressed by longeing.
                                    Susan B.


                                    • Original Poster

                                      Plumpcreek - I am so glad to hear that surgery helped your mare so well. It sounds like it went perfectly.

                                      I am not aware of any one doing this surgery around here. Also, it is not really a option (at this time) for my horse. We are still not sure that ks is the problem. The vets don't really think so. The vertebrae are lightly touching and the x-rays look horrible to me. But, the vets dissagree with me. Even my chiro dissagrees.

                                      He has been such a puzzle... mostly because when I get to New Bolton I show a sound horse. I think due to the adrenilin. He is wired when we get there and stays wired being in a stall. However, at home he is reactive.

                                      NCSue - I agree with you totally. I worry that the gabapentin may mask an issue. But, I am desperate at this point. I have been at this wellover a year. I know that his front right is an issue. The coffin joint has been injected. But the changes are minor. However, when he is shod (in natural balance shoes, front only - size 5 feet) he is very uncomfortable when the farrier holds the front left. He will lean and hollow his back sometimes. It always bothers me... but I still can not find a link there to everything else. Any thoughts? He does have x-rays of the front right as well a bone scan.


                                      • Original Poster

                                        trail blazer - I have read a little on Mesotherapy but not recently. I will go back and look into it again. Thank you!